Healthcare Provider Details

I. General information

NPI: 1114836004
Provider Name (Legal Business Name): KELSIE LORRAINE BARGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SHERROUSE AVE
MONROE LA
71203-4516
US

IV. Provider business mailing address

2006 TOWER DR
MONROE LA
71201-5036
US

V. Phone/Fax

Practice location:
  • Phone: 318-388-3747
  • Fax:
Mailing address:
  • Phone: 318-325-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10127
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: